Hepatitis C Virus and Hispanic Criminal Justice Clients: A Missed Opportunity

Hepatitis C Epidemiology in a Large Urban Jail: A Changing Demographic

OBJECTIVES

Nearly 1 in 3 people with hepatitis C virus (HCV) infection pass through the criminal justice system annually; the system is a crucial location for HCV screening, education, and linkage to care. We aimed to (1) determine the prevalence and incidence of HCV antibody positivity and (2) evaluate the demographic characteristics of people with HCV in a large urban jail.

METHODS

We offered universal opt-out HCV testing to any person undergoing a routine blood test at the Dallas County Jail from June 2015 through December 2019 (N = 14 490). We extracted data on demographic characteristics from the electronic medical record and collected data on risk factors from people with HCV antibody positivity. We performed univariate and multivariate analyses.

RESULTS

The prevalence of HCV antibody positivity was 16.7%; the incidence was 13.5 cases per 1000 person-years. HCV antibody positivity was significantly associated with older age (P < .001), female sex (P = .004), non-Hispanic White race versus non-Hispanic Black race (P < .001), and being released to prison versus not (P < .001). Among people born after 1965, those who were HCV antibody-positive were more frequently non-Hispanic White and Hispanic women, whereas among those born in 1965 or before, those who were HCV antibody-positive were more frequently non-Hispanic Black men.

CONCLUSIONS

The high prevalence and incidence of HCV antibody positivity in a large county jail argue for routine, universal HCV testing and prevention counseling in criminal justice settings. Changing demographic characteristics mirror those of the national injection drug use epidemic and shed insight into designing interventions for risk reduction, education, linkage to care, and treatment.

Negative implicit in-group stereotypes of Chinese male drug abusers: evidence from ERP

Psychological dependence is the most important factor leading to relapse, few studies have examined whether in-group stereotypes exist in drug abusers, while it's helpful for drug abusers in getting rid of psychological dependence. To investigate the presence of in-group stereotypes and the neural mechanisms in drug abusers, two experiments were designed in this study. Experiment 1 used a classification-verification paradigm and Experiment 2 used The Extrinsic Affect Simon Task (EAST), simultaneous collection of EEG data from China. 18 and 17 males were analyzed respectively in Experiment 1 and 2. The results in Experiment 1 showed that (1) there was no significant difference in reaction times or N400 amplitude between the condition "Drug abusers-Negative words" and the condition "Drug abusers-Positive words". In Experiment 2, we found that (2) participants in the condition "Drug abusers-Negative words" scored higher in accuracy rates than in the condition "Drug abusers-Positive words". (3) Participants in the condition "Drug abusers-Negative words" were shorter than "Drug abusers-Positive words" in reaction times (RTs). (4) Participants in the condition "Drug abusers-Negative words" were lower than "Drug abusers-Positive words" in the peak of N400. The conclusion is that there are significant negative implicit in-group stereotypes among Chinese male drug abusers. The experimental results and the uniqueness of Chinese male drug abusers in this study were discussed.

Awareness and Epidemiology of Chronic Hepatitis C Virus Infections in Florida

Introduction

Progress towards achieving hepatitis C virus (HCV) elimination in Florida has been hampered by barriers to screening, linkage to care, and treatment. This study aims to describe the HCV care cascade and patient characteristics in Florida.

Methods

This analysis combined HCV-related laboratory data and patient characteristics from two, large US laboratory datasets that included individuals tested for HCV antibody (Ab) and HCV ribonucleic acid (RNA) viral load between January 2015 and December 2019. A decline in sequential HCV RNA viral loads was used to impute HCV treatment. Machine-learning algorithms were used to identify cured patients. The actual number of individuals with HCV Ab screening, and the number and percentage of persons who were HCV RNA-positive and treated, were calculated.

Results

The number of persons in Florida diagnosed as HCV RNA-positive was 31,659 in 2019. The number of individuals HCV Ab screened in 2019 was 1,024,379, an increase of 82.5% from 2015. The percentage of HCV Ab-positive individuals was 4.1%, demonstrating a 16.2% decrease from 2015. The percentage of HCV RNA-positive patients who were treated was 27.0%, a 10.5% decrease from 2015 to 2019.

Conclusion

An Ab positivity rate > 4-times higher than national estimates with increased screening among baby boomers, but decreased screening among younger individuals, suggests risk-based screening is still common practice in Florida, despite universal screening recommendations. Public health efforts to decrease barriers to screening, linkage to care, and treatment are needed to reduce the burden of HCV in Florida and to ensure progress toward virus elimination.